Healthcare Provider Details

I. General information

NPI: 1578528790
Provider Name (Legal Business Name): HOME CARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 11/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6202 CONSTITUTION DR SUITE C
FT WAYNE IN
46804-1583
US

IV. Provider business mailing address

6202 CONSTITUTION DR SUITE C
FT WAYNE IN
46804-1583
US

V. Phone/Fax

Practice location:
  • Phone: 260-459-2917
  • Fax: 260-459-2894
Mailing address:
  • Phone: 260-459-2917
  • Fax: 260-459-2894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number06-004060-1
License Number StateIN

VIII. Authorized Official

Name: MRS. CHRISTI C. EVERSON RN
Title or Position: PRESIDENT/ ADMINISTRATOR
Credential: RN
Phone: 260-459-2917